In the perinatal and early postnatal period, congenital (antenatal) and intrauterine (intra- and perinatal) CMV are more often manifested by lesions of the liver, brain and organ of vision. Objective. To study the effect of pathogenetic therapy with the metabolic and hepatoprotective drug N-Pentoxinial on the course of persistent CMV/EBV infection of perinatal genesis in children. Material and Methods. The course of latent perinatal cytomegalovirus (CMV) and Epstein-Bar viral infections in children was studied against the background of antiviral treatment (specific against CMV/ EBV immunoglobulin - Neocytect and recombinant alpha-interferon - Viferon No. 10), followed (immediately after 5-7 days after antiviral) by the appointment of 1-2 courses of N-Pentoxinal for 10-20 days. The main group consisted of 20 children (average age 5.4±1.4 years), the control group consisted of 10 children (average age 5.1±1.7 years). All underwent general clinical and virological studies to confirm the diagnosis. Result and discussions. The results obtained indicate that the addition of N-pentoxynial to the basic antiviral therapy for CMV and EBV infection in children improves (accelerates) the elimination of the virus from biological fluids (blood and urine), as well as more rapid normalization of transaminases and alkaline phosphatase. There were no reliably proven allergic reactions. Conclusions. The drug N-Pentoxinial can be prescribed after antiviral therapy for perinatal CMV, EBV infection in order to consolidate the results of antiviral treatment and normalize liver function, especially bile secretion. Keywords: latent perinatal cytomegalovirus/Epstein-Barr viral infection, children, therapy.

Tuberous sclerosis (Pringle-Burneville disease) is a polysystemic genetic disease and occurs in the population with a frequency of 1:50000. Objective of the study. To study neuropsychic status and dynamics of tuberous sclerosis development in children. Material and Methods. Have been examined 33 children aged from 1 to 14 years, who were observed in the neurological pediatric department of the University Clinic ("Aksay") of Asfendiyarov KazNMU. All children had apigmented spots and coffee-milk stains on the torso and extremities, not protruding above the skin level. All children showed characteristic neuroimaging changes in the brain by magnetic resonance imaging (MRI) and computed tomography (CT) - areas of dyshinesia cortically and subcortically, i.e. tubercles. As well as changes in internal organs (hamartoma variants). All children underwent a complete laboratory examination (general blood count, standard biochemical parameters), electroencephalography of the brain (EEG), as well as ultrasound examination of internal organs. Results and conclusions. As a result of our study, it was revealed that the main symptom confirming the diagnosis of tuberous sclerosis is the presence of tubers (95-100% of patients). Moreover, there is a topographical relationship between tubers detected during MRI examination and the presence of foci on the EEG. Thus, a particular manifestation of the disease in patients is symptomatic epilepsy with onset in the first months of life (96% of patients). Keywords: tuberous sclerosis, epilepsy, children, hamartomas, pigmented spots, cortical dysgenesis, tubers.

Introduction: There are several diseases recognized as variants of MS: post-infectious acute disseminated encephalitis, multiple sclerosis (MS), Rasmussen leukoencephalitis and Schilder's leukoencephalitis and related, but separate neuroimmune condition – Neuromyelitis Devic’s. In Kazakhstan diagnosis of such diseases was rare and immune modified treatment was only admitted after the age of 18. Clinical and immunogenetic study of MS spectrum diseases in Kazakhstan would allow to justify early targeted treatment. Objective: The aim of the study was to investigate genes of the main complex of human histocompatibility (MHC) associated with diseases of MS spectrum in Kazakhstani population. Methods: Complex clinical, neuroimaging and immunogenetic studies were performed in 34 children (24 girls, 10 boys) aged 4 to 18 years. 21 children were diagnosed with MS (11 Kazakh origin and 10 – Russian; 4 boys, 17 girls), 7 with leucoencephalitis (all Kazakh, 5 boys, 2 girls) and 6 with Devic neuromyelitis optica (all Kazakh, 1 boy, 5 girls). Genotyping of HLA DRB1, DQA1, DQB1 genes was performed for all patients. Results: MS group was characterized by classical relapsing-remitting MS. Predominant haplotype as a linkage complex was DRB1*15:01~DQA1*01:02~DQB1*06:02 in 20 (47.6%) of 42 DR-alleles, in 16 (76.2%) patients. MS relative risk (RR) was 13,36 for ethnic Kazakhs and RR=5,55 in Russians. Leukoencephalitis had 7 children, with 28.6% mortality rate. The haplotype DRB1*15:01~DQA1*01:02~DQB1*06:02 as a linkage complex was detected 3 patients (4 alleles), RR=5,88. Devic’s neuromyelitis optica (NMO) clinical course was characterized by fast and prolonged progression. There was predominance of DRB1*14 allele with RR=3,38. Conclusion: Summarizing, in the Kazakh population the haplotype DRB1*15:01∼DQA1*01:02∼DQB1*06:02 as a linkage complex was associated with prediction to MS and leukoencephalitis, but not to Devic’s NMO. Our study highlights the importance of awareness of MS and related disorders diagnosis which allows to implement early admission of disease-modified treatment in pediatric MS in Kazakhstan.